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NPI Code Detail

MEDICARE: ANNE STULL MA

MEDICARE: ANNE STULL MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-08-4154NC
2103T00000XPsychologist3621NC

General Provider Information

NPI Number : 1457593741
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE STULL MA
Provider Business Mailing Address
First Line : 5121 KINGDOM WAY STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6063
Country : US
Telephone Number : 919-865-5077
Fax Number : 919-882-8661
Provider Business Practice Location Address
First Line : 5121 KINGDOM WAY STE 100
Second Line :
City : RALEIGH
State : NC
Zip : 27607-6063
Country : US
Telephone Number : 919-865-5077
Fax Number : 919-882-8661
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2009
Last Update Date : 05/07/2021

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Directions to “ ANNE STULL MA” Practice Location

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